In the fifth part of our series, we show you some instruments that are mainly used in trauma surgery, orthopedics, and gynecology. We already presented typical grasping and cutting instruments from visceral surgery in the last article, and these are, of course, used in all surgical areas in a wide variety of designs and sizes used.
An instrument that is used in all surgical fields is the sharp spoon. With it, the surgeon can ablate wounds in fresh necrosis and generally remove unwanted tissue superficially. The trauma surgeon can use very small spoons to clean up fracture gaps from small fragments. Larger spoons are often used to scrape off unwanted soft tissue on the bone.
There are chisels in abundance in trauma General Surgery Instruments. Our smallest chisels are one to two millimeters wide. The largest chisels in this area are up to 30 millimeters wide. The chisels can be roughly divided into hollow and flat chisels. Flat chisels are used for osteotomy or generally to remove bone material. Gouges are used to remove protruding bone material such as osteophytes.
Chisels are usually always handed with an appropriate hammer. Large hammers can weigh a kilogram or more. When handing both instruments at the same time, the hammer is held by the hammerhead so that the user can take hold of the handle. At the same time, the chisel is placed in the middle of the shaft so that it can be picked up by the handle. This prevents someone from injuring themselves on the ground and sharp chisel blades.
The gouge pliers usually referred to as a Luer actually have nothing to do with a chisel. It is a sharp tissue or bone gripping forceps, the mouth of which is hollow, and the areas of the barrel are sharpened. It is used to roughly remove excess or unwanted bone tissue. In spinal surgery, for example, spinous processes are removed with the Luer.
Gynecology likes to use Breiskys to keep tissue away from below. They differ from conventional retractors – such as Longneck – in that they have a straight handle and cranked holding surface and are often used in the vagina. But they are also often used by gynecologists for abdominal interventions, especially when they operate in the Douglas.
Different specula are used to disinfect and inspect the vagina. The back sheet is actually a gutter speculum; it is placed on the rectum in the vagina. The front sheet is to hold the bladder pillar away.
In gynecology, two types of curettes are distinguished: Sharp curettes are used to scrape and extract tissue from the cervix and the corpus of the uterus in order to be able to examine it histologically. With blunt curettes, placental remnants are scraped off after abortions or after childbirth, whereby an injury to the uterus wall is to be prevented, as this could be more easily injured by pregnancy. Usually, these can also be distinguished by clear corrugations or a raised point on the handle.